Provider Demographics
NPI:1740409804
Name:MOTTER, CONSTANCE S (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:S
Last Name:MOTTER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6806 KINGS WAY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-3121
Mailing Address - Country:US
Mailing Address - Phone:330-655-0535
Mailing Address - Fax:330-543-3677
Practice Address - Street 1:ONE PERKINS SQUARE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308
Practice Address - Country:US
Practice Address - Phone:330-543-8792
Practice Address - Fax:330-543-3677
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS